<form id="edit-form" class="form-horizontal" role="form" data-toggle="validator" method="POST" action="">

    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Name')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-name" class="form-control" name="row[name]" type="text" value="{$row.name|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Mobile')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-mobile" class="form-control" name="row[mobile]" type="text" value="{$row.mobile|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Shop')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-shop" class="form-control" name="row[shop]" type="text" value="{$row.shop|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Cardname')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-cardname" class="form-control" name="row[cardname]" type="text" value="{$row.cardname|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Cardnumber')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-cardnumber" class="form-control" name="row[cardnumber]" type="text" value="{$row.cardnumber|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Account')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-account" class="form-control" name="row[account]" type="text" value="{$row.account|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Cardtype')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-cardtype" class="form-control" name="row[cardtype]" type="text" value="{$row.cardtype|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Cardstatus')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-cardstatus" class="form-control" name="row[cardstatus]" type="text" value="{$row.cardstatus|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Cardopeningtime')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-cardopeningtime" class="form-control datetimepicker" data-date-format="YYYY-MM-DD HH:mm:ss" data-use-current="true" name="row[cardopeningtime]" type="text" value="{:$row.cardopeningtime?datetime($row.cardopeningtime):''}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Openingshop')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-openingshop" class="form-control" name="row[openingshop]" type="text" value="{$row.openingshop|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Cardprice')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-cardprice" class="form-control" name="row[cardprice]" type="text" value="{$row.cardprice|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Periodvalidity')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-periodvalidity" class="form-control" name="row[periodvalidity]" type="text" value="{$row.periodvalidity|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Leftamount')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-leftamount" class="form-control" name="row[leftamount]" type="text" value="{$row.leftamount|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Leftgiftamount')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-leftgiftamount" class="form-control" name="row[leftgiftamount]" type="text" value="{$row.leftgiftamount|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Leftsecondaryamount')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-leftsecondaryamount" class="form-control" name="row[leftsecondaryamount]" type="text" value="{$row.leftsecondaryamount|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Leftsecondarytimes')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-leftsecondarytimes" class="form-control" name="row[leftsecondarytimes]" type="text" value="{$row.leftsecondarytimes|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Leftsecondarygifttimes')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-leftsecondarygifttimes" class="form-control" name="row[leftsecondarygifttimes]" type="text" value="{$row.leftsecondarygifttimes|htmlentities}">
        </div>
    </div>
    <div class="form-group layer-footer">
        <label class="control-label col-xs-12 col-sm-2"></label>
        <div class="col-xs-12 col-sm-8">
            <button type="submit" class="btn btn-primary btn-embossed disabled">{:__('OK')}</button>
        </div>
    </div>
</form>
